Recovery Point Research Articles

Cross-flow filtration of lees grape juice for non-aromatic white wine production: a case study on an Italian PDO

During white winemaking, after clarification, a considerable amount of juice remains trapped in the lees. Recently, cross-flow filtration has become popular to recover a large amount of juice from lees. However, high juice recovery is observed to be consistent with a decrease in wine quality, while low recovery reduces the amount of wine that can be produced. Therefore, this study aims to find the optimal compromise between quantity and quality. We tested at industrial scale and in three replicates, qualitative changes in an elite Italian white wine as a function of different amounts of juice recovered. The length of the filtration cycle affected the juice’s chemical parameters. In some cases, uncontrolled alcoholic fermentation started before the yeast inoculum, leading to a small increase in ethanol, and higher acetic acid and ethyl acetate concentrations that can be find in the resulting wines. The phenomenon was particularly apparent in longer fermentation cycles. Furthermore, longer filtration cycles increased juice acidity and potassium, while the resulting wines changed in terms of pH, glycerol, and volatile profile. Several grape-related compounds were found in wines at different concentrations as a function of the amount of juice recovered. In particular, Z3-hexen-1-ol, p-cymene, β-ionone, and benzyl alcohol were found to increase, reaching a maximum at 65% of recovered juice before decreasing. Furthermore, several fermentation-related compounds were found to change according to the length of the filtration cycle. Our work identifies an optimal recovery point of 65%. This percentage appears the best trade-off between the flavor of wines, fermentation risk management, and the amount of juice recovered.

Trajectories and determinants of functional limitations in late-life depression: A 2-year prospective cohort study

BackgroundIn mental health research, functional recovery is increasingly valued as an important outcome in addition to symptomatic remission. MethodsCourse types of functional limitations among depressed older patients and its relation with symptomatic remission were explored in a naturalistic cohort study (Netherlands Study of Depression in Older persons). 378 depressed older patients (≥60 years) and 132 non-depressed persons were included. Depressive disorders were assessed with Composite International Diagnostic Interview at baseline and two-year follow-up. Functional limitations were assessed every 6 months with the World Health Organization Disability Assessment II. ResultsDepressed patients had more functional limitations compared to their non-depressed counterparts. Growth Mixture Modeling among depressed patients identified two trajectories of functional limitations, both starting at a high disability level. The largest subgroup (81.2%) was characterized by a course of high disability levels over time. The smaller subgroup (18.8%) had an improving course (functional recovery). After two years, the main predictor of functional recovery was the remission of depression. Among symptomatic remitted patients, female sex, higher level of education, higher gait speed, and less severe depression were associated with no functional recovery. Non-remitted patients without functional recovery were characterized by the presence of more chronic somatic diseases, a lower sense of mastery, and a higher level of anxiety. Conclusions1 in 5 depressed older patients have a course with functional recovery. Combining functional and symptomatic recovery points to a subgroup of older patients that might profit from more rigorous psychiatric treatment targeted at psychiatric comorbidity and a group of frail depressed older patients that might profit from integrated geriatric rehabilitation.

Harnessing tipping points in complex ecological networks.

Complex and nonlinear ecological networks can exhibit a tipping point at which a transition to a global extinction state occurs. Using real-world mutualistic networks of pollinators and plants as prototypical systems and taking into account biological constraints, we develop an ecologically feasible strategy to manage/control the tipping point by maintaining the abundance of a particular pollinator species at a constant level, which essentially removes the hysteresis associated with a tipping point. If conditions are changing so as to approach a tipping point, the management strategy we describe can prevent sudden drastic changes. Additionally, if the system has already moved past a tipping point, we show that a full recovery can occur for reasonable parameter changes only if there is active management of abundance, again due essentially to removal of the hysteresis. This recovery point in the aftermath of a tipping point can be predicted by a universal, two-dimensional reduced model.

P‐2.1: Effects of vergence parameters on asthenopia of patients with convergence insufficiency

Purpose: patients with convergence insufficiency always have asthenopia during near work., but we found the signs and the symptoms did not match in part of patients. In this study, we want to investigate the effect of vergence parameters on asthenopia of patients with convergence insufficiency, and find some parameters to reflect the level of asthenopia.Method: We recruited 58 patients with convergence insufficiency from Eye Hospital in Wenzhou Medical University (34 Males, 24 Female, Age 22.67±9.33 years) randomly, excluding strabismus, eye disease, trauma, anisometropia and dysfunction of accommodation. Patients were divided into three groups according to the values of symptom questionnaires using CISS, 20 patients in severe group, 19 in moderate group, and 19 in mild group, respectively. We analyzed the near phoria (PD/PN), near blur point (PB), the relationship between recover point ( PR) and level of asthenopia. We used the Sheard's rule: PSheard=2/3*PN‐1/3PB, and the difference value between phoria and recovery point: PR‐N=PR‐PN (PD/PN was exophoria using positive value). PSheard>0 means it was not match the Sheard's rule. PR‐N<0 means recover point is smaller than phoria.Result: PN in sever group, moderate group and mild group was −9.50Δ±4.06Δ, −4.95Δ± 3.14Δ, −13.63Δ± 5.39Δ, respectively, the difference between each two groups are significant(F=19.46, P=<0.001). PSheard in sever group, moderate group and mild group was 1.90 Δ ± 3.02 Δ, −2.07 Δ ± 3.00 Δ, 3.42 Δ ± 3.06 Δ, respectively. There are statistically significant difference between moderate group and mild group, and between moderate group and severe group (P<0.05). In moderate group, PSheard <0, means it matched the Sheard's rule. The other two groups could not match the Sheard's rule. PR‐N in sever, moderate, mild group was (−5.85Δ±3.24Δ; 95%CI: −7.37Δ, −4.33Δ), (0.63Δ±4.62Δ; 95%CI: −1.59Δ, 2.86Δ), (−11.63Δ±6.53Δ; 95%CI: −14.78Δ, −8.49Δ), respectively. There were statistically significant difference between each two groups(F=29.13, P<0.001).Conclusions: The relationship between phoria and recover point will influence the grade of asthenopia of CI patients. Asthenopia may appear when the value of recover point is close to phoria, if PR‐N is smaller than 2.86Δ (95%CI of moderate group). And intermittent suppression may appear at near tasks to alleviate symptoms, while PR‐N is smaller than ‐8.49Δ (95%CI of mild lever group).

Assessing the resilience of an IT portfolio

One of the goals of the business impact analysis (BIA) process is to establish recovery objectives. Having established recovery objectives, the next step is to assess whether one’s IT portfolio can actually meet those objectives. Unfortunately, there is no well-defined and prescriptive process for this. This article describes a model that can be customised and applied in any organisation to take an IT-centric view to assessing resilience capabilities. The first stage of this process is to gather IT-specific data, either through a questionnaire or by querying the configuration management database directly. The next step is to leverage a set of scoring rubrics in order to assess the capabilities of each application with respect to meeting recovery point objectives, recovery time objectives and service-level targets, as well as the strength of staffing, documentation and disaster recovery plans. The output of the model is a composite score for each application (based upon an aggregate capability score and a weighting factor) that identifies those services in the IT portfolio with the greatest gaps in their capabilities (ie those services in greatest need of remediation). The logic of the model can either be built with spreadsheets or automated through business continuity management planning platforms.

Developing the Spirituality in Recovery Framework: The Function of Spirituality in 12-Step Substance Use Disorder Recovery

A large portion of substance use disorder recovery research has incorporated the study of mutual-aid 12-Step programs and faith-based programs. However, spirituality as a centerpiece of substance use disorder recovery, as an actionable or operationalized means of transformative change, is not well studied. As many individuals in recovery point to spirituality as the chief means by which they have overcome their substance use disorder, this represents a significant gap in the current literature. Though spirituality is difficult to operationalize and measure, several previous studies have examined aspects of the role of spirituality in the recovery process. This current article puts forth a theoretical framework in which leading articles involving spirituality in recovery are synthesized in order to inform a functional, theoretical model of change that can be utilized in future research design.

Comparative study on visual fatigue caused by watching liquid crystal display and projection display

Objective: To explore the effect of different types of visual display terminals (VDT) on visual fatigue. Methods: A total of 68 subjects were enrolled and divided into flat screen group, metal screen group and glass bead screen group. The subjects watched a video in the same environment for 60 minutes. Before and after watching, they were asked to fill in a visual fatigue rating scale and underwent visual function examinations. The blink rate of subjects was recorded during the experiment. Results: After watching the video, for the metal screen, glass bead screen, and flat screen group respectively: (1)The median (interquartile range, IQR) of visual fatigue rating increased significantly (before: 1.0 (1.2), 1.3 (1.6), 0.5 (0.9); after: 2.1 (1.9), 2.1 (1.7), 1.2 (1.0); Z=-4.72, -4.83, -3.75; all P<0.05). (2) The median (IQR) of blink frequency increased significantly (before: 11.5 (10.6), 15.3 (11.9), 7.0 (13.0) times/minute; after: 15.0 (13.0), 17.0 (16.0), 15.0 (12.0) times/minute; Z=-2.64, -2.74, -4.12; all P<0.05). (3) The mean (±standard deviation) of critical flicker fusion frequency (CFF) decreased significantly [before: (35.76±2.98), (35.84±2.79), (35.44±2.21) Hz; after: (35.09±2.78), (34.94±2.67), (34.57±2.33) Hz; t=-2.64, -2.38, -4.12; all P<0.05). (4)The median (IQR) of near point of convergence (NPC) became significantly larger [before: 3.9 (2.6), 4.0 (2.5), 4.3 (2.7) cm; after 5.4 (3.8), 4.8 (2.7), 6.1 (3.9) cm; Z=-3.39, -2.27, -3.36; all P<0.05]. (5)The median of negative relative accommodation (NRA) reduced significantly [before: 2.00 (0.50), 2.00 (0.56), 2.00 (0.25) cm; after 1.75 (0.50), 1.75 (0.25), 1.75 (0.50) cm; Z=-1.98, -2.09, -2.53; all P<0.05]. Meanwhile, no significant changes were found for the positive relative accommodation (PRA), accommodative amplitude, accommodative response, negative relative vergence in all groups after watching the video. The comparisons between the three groups showed that, after watching the video, the participants in the two kinds of projection screen group (the metal and glass bead screen group) had more subjective visual fatigue than those in the flat screen group respectively (Z=-2.09, -2.21; all P<0.05), while there was no significant difference in subjective visual fatigue between the two projection screen groups (P>0.05). In addition, positive fusional vergence recovery point and break point decreased after watching the video in the metal screen and glass bead screen group, respectively (t=4.15, 2.07; all P<0.05). However, no such change was found in the flat screen group. Conclusions: Short-term and long-distance VDT operations have significant effects on visual fatigue, which may be due to the decreased positive convergence ability. VDT operations over projection screens may result in more visual fatigue than LED flat panel display, while the effect of different projection screen types have insignificant influences on visual fatigue. (Chin J Ophthalmol, 2019, 55:595-600).

Care Coordination Can Reduce Unmet Needs of Persons With Severe and Persistent Mental Illness.

Introduction: Persons with severe and persistent mental illness (SPMI) have multiple and complex needs, many of which are not health related. Mental health services are unable to address these needs without collaboration with other agencies. In the absence of this collaboration, persons with SPMI often fall through the system cracks and are unlikely to experience recovery. Furthermore, previous studies have shown that unmet accommodation needs are associated with unmet needs in other areas. This study aimed to ascertain whether a care coordination model adopted in Australia’s Partners in Recovery [PIR] initiative was able to reduce unmet needs in such persons and also if meeting accommodation needs were associated with meeting other needs. Methods: This was a longitudinal study where met and unmet needs of clients measured using the Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS) were compared at enrolment and exit from the PIR initiative. Logistic regression was used to examine the association between change in accommodation needs and change in other CANSAS variables. Results: In total, 337 clients (66% of 508 clients) had both baseline and follow-up data and were seen within the time frame of 14 to 101 weeks. At baseline, the most frequently reported unmet needs were psychological distress, daytime activity, and company (89%, 72%, and 67%, respectively). At follow-up, these had decreased to 27%, 22%, and 22%, respectively. The proportions of clients with an unmet need at baseline who subsequently progressed to having that need met at follow-up ranged between 62% and over 90%. Change in accommodation needs from unmet to met was associated with changes in monetary needs and needs related to childcare, food, safety to self, education, and access to other services, with the greatest change seen for monetary needs (adjusted OR 2.87, 95% CI 1.76, 4.69). Conclusions: Reducing needs of persons with SPMI is the starting point of recovery and is a good indicator of psychiatric care. Care coordination is a useful way to address multiple and complex needs of persons with SPMI. While addressing needs, priority must be given to meeting accommodation needs.

Quartz crystal microbalance coated with PEDOT–PSS/PVA nanofiber for a high-performance humidity sensor

Abstract. Quartz crystal microbalance (QCM) coated with poly(3,4-ethylenedioxythiophene) and polystyrene sulfonate mixed with polyvinyl alcohol (PEDOT–PSS/PVA) nanofiber has been fabricated as a humidity sensor using the electrospinning method. Three types of PEDOT–PSS/PVA nanofiber sensors are fabricated with different needle-to-collector electrospinning distances. The scanning electron microscope images confirm the presence of beads in the nanofiber structure. The results show that the sensor mass deposition increased with the decrease in needle-to-collector distance. The best sensor performance is exhibited by the sample with medium needle-to-collector distance (QCM NF 2). The QCM NF 2 nanofiber sensor shows excellent sensitivity of up to 33.56 Hz per percentage point of relative humidity, with rapid response (5.6 s) and recovery (3.5 s) times, good linearity, excellent repeatability, low hysteresis, and long-term stability and response. The QCM PEDOT–PSS/PVA nanofiber sensor provides a simple method to fabricate high-performance humidity sensors.

Surgical treatment of cervical spondylosis in patients 80 years of age and older-A retrospective observational study.

The older adult population in developed countries is rapidly increasing, as is the number of older adults with cervical spondylosis. Previous studies on the surgical outcomes of older adults with cervical spondylosis have reported contradictory results. This study aimed to compare the surgical outcomes in adults with cervical spondylosis who were <80 and ≥80 years old. We retrospectively investigated data from adults who underwent surgical treatment for cervical spondylosis between 2006 and 2016. The clinical outcomes and postoperative complications of patients who were <80 years old were compared to those of patients who were ≥80 years old. Of the 108 patients included in the study, 14 (13.0%) were ≥80 years old. The preoperative neurosurgical cervical spine score was significantly different between patients who were <80 (9.1 ± 2.4) and ≥80 (6.1 ± 2.1) years old (p < .001). The recovery rate was 58.2 ± 30.0% and 41.3 ± 24.7% in patients who were <80 and ≥80 years old, respectively (p = .05). However, the number of recovery points scored was 2.8 ± 2.0 and 3.4 ± 2.3 in patients who were <80 and ≥80 years old, respectively, which was not significantly different. Although 12 patients had medical comorbidities, they had no surgical complications. This study clarifies the benefits of surgical treatment for older adults with cervical spondylosis. Generally, older adults have lower recovery rates and are unlikely to experience full recovery; however, surgery for cervical spondylosis appears to improve patients’ quality of life.

Periodistas valencianos de los años 20 y 30. Algunos nombres de referencia de la generación del exilio de 1939

Durante los años 20 y 30 del siglo XX surgió en el País Valenciano una generación de periodistas entre los que se encuentran algunas de las firmas más destacadas del periodismo valenciano de todos los tiempos. Paradójicamente, se trata de trayectorias que han quedado desdibujadas por las circunstancias históricas, fundamentalmente por el exilio republicano. Este trabajo parte de la selección de aquellos más relevantes, desde una perspectiva periodística profesional. Atendiendo a su trayectoria y su producción, se han seleccionado los más relevantes para reconstruir sus biografías profesionales como punto de partida para su recuperación como grupo y el posterior estudio de su obra.

Reduced Upper Limb Recovery in Subcortical Stroke Patients With Small Prior Radiographic Stroke.

Background: Research imaging costs limit lesion-based analyses in already expensive large stroke rehabilitation trials. Despite the belief that lesion characteristics influence recovery and treatment response, prior studies have not sufficiently addressed whether lesion features are an important consideration in motor rehabilitation trial design.Objective: Using clinically-obtained neuroimaging, evaluate how lesion characteristics relate to upper extremity (UE) recovery and response to therapy in a large UE rehabilitation trial.Methods: We reviewed lesions from 297 participants with mild-moderate motor impairment in the Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) study and their association with motor recovery, measured by the UE Fugl-Meyer (UE-FM). Significant lesion features identified on correlational and bivariate analysis were further analyzed for associations with recovery and therapy response using longitudinal mixed models.Results: Prior radiographic stroke was associated with less recovery on UE-FM in participants with motor impairment from subsequent subcortical stroke (−5.8 points) and in the overall sample (−3.6 points), but not in participants with cortical or mixed lesions. Lesion volume was also associated with less recovery, particularly after subcortical stroke. Every decade increase in age was associated with 1 less point of recovery on UE-FM. Response to specific treatment regimens varied based on lesion characteristics. Subcortical stroke patients experienced slightly less recovery with higher doses of upper extremity task-oriented training. Participants with cortical or mixed lesions experienced more recovery with higher doses of usual and customary therapy. Other imaging features (leukoaraiosis, ischemic vs. hemorrhagic stroke) were not significant.Conclusions: ICARE clinical imaging revealed information useful for UE motor trial design: stratification of persons with and without prior radiographic stroke may be required in participants with subcortical stroke, the majority of motor rehabilitation trial participants. Most of the prior radiographic strokes were small and cortically-based, suggesting even minor prior brain injury remote to the acute stroke lesion may limit spontaneous and therapy-related recovery. Lesion location may be associated with response to different therapy regimens, but the effects are variable and of unclear significance.

Brain ventricular volume changes induced by long-duration spaceflight

Long-duration spaceflight induces detrimental changes in human physiology. Its residual effects and mechanisms remain unclear. We prospectively investigated the changes in cerebrospinal fluid (CSF) volume of the brain ventricular regions in space crew by means of a region of interest analysis on structural brain scans. Cosmonaut MRI data were investigated preflight (n = 11), postflight (n = 11), and at long-term follow-up 7 mo after landing (n = 7). Post hoc analyses revealed a significant difference between preflight and postflight values for all supratentorial ventricular structures, i.e., lateral ventricle (mean % change ± SE = 13.3 ± 1.9), third ventricle (mean % change ± SE = 10.4 ± 1.1), and the total ventricular volume (mean % change ± SE = 11.6 ± 1.5) (all P < 0.0001), with higher volumes at postflight. At follow-up, these structures did not quite reach baseline levels, with still residual increases in volume for the lateral ventricle (mean % change ± SE = 7.7 ± 1.6; P = 0.0009), the third ventricle (mean % change ± SE = 4.7 ± 1.3; P = 0.0063), and the total ventricular volume (mean % change ± SE = 6.4 ± 1.3; P = 0.0008). This spatiotemporal pattern of CSF compartment enlargement and recovery points to a reduced CSF resorption in microgravity as the underlying cause. Our results warrant more detailed and longer longitudinal follow-up. The clinical impact of our findings on the long-term cosmonauts' health and their relation to ocular changes reported in space travelers requires further prospective studies.

A QCM-D sensing strategy for investigating the real-time effects of oxidative stress on the viscoelastic properties of pre-osteoblast cells

Oxidative stress results from an imbalance in the cellular redox state which can cause damage to the cell cytoskeleton and morphology, thereby affecting cell viscoelasticity. In this study, we introduce a quartz crystal microbalance with dissipation (QCM-D) sensing strategy that enables the real-time assessment of the changes in the viscoelastic properties of an MC3T3 cell monolayer in response to oxidative stress. This was successfully achieved by tracking the changes in energy dissipation (ΔD-response) caused by the interaction of H2O2 with the cell monolayer adhered to a poly-d-lysine-coated polystyrene quartz sensor. While a return to baseline values of the ΔD-response was obtained at 325 min (recovery point) after the incubation of cells with 25 μM H2O2, higher concentrations (50 μM-10 mM) exhibited no recovery. We successfully validated using scanning electron, atomic force and fluorescence microscopy that at the recovery point the cell morphology recovered from 25 μM H2O2 exposure, whereas, higher concentrations (50 μM-10 mM) resulted in the shrinkage of the cytoskeleton, alteration in cell morphology, and decrease in cell density due to apoptosis/necrosis, supported by a cell viability assay. Finally, total antioxidant capacity assay (TAC) confirmed that while cells’ metabolic state recovered from 25 μM H2O2 treatment, higher H2O2 concentrations led to a decline in the TAC. Altogether, these results showed that the viscoelastic properties of cells can be used to investigate cell recovery from oxidative stress, which may allow us to distinguish oxidative eustress from distress. Overall, we have demonstrated that QCM-D is a viable tool for measuring the effects of oxidative stress on the viscoelastic properties of MC3T3 cells.

Field Conservation of Skeletal Remains: Stabilization Treatment Techniques and Implications for Future Analysis

AbstractThe information potential of human skeletal remains—as for any excavated material—is impacted by the conditions of archaeological burial, and the environments and actions experienced during subsequent excavation, laboratory processing, study, and storage. A conservation approach emphasizes the mitigation of threats to material stability and integrity, which for excavated collections are often most critical at the point of archaeological exposure and recovery. Conservation techniques involving application of modern synthetic materials for stabilizing skeletal remains in the field are discussed, using case examples primarily from terrestrial archaeological projects in Mesoamerica. The potential effects of the use of various conservation materials on results of biomolecular instrumental analysis are included.

An Aircraft Conflict Resolution Model Based on Geometric Optimization

A geometrically optimal conflict detection and resolution method was proposed to make up for the defect of current methods in engineering applications conflict resolution. Firstly, the conflict resolution point of the problem is defined, at which point the possible flight conflicts between aircrafts are predicted; Secondly, the same direction same angle (SDSA) is adopted to solve the flight conflict, that is, the two aircrafts turn the same angle to the same side at the same time on the original track to obtain a new track crossing point, namely a track recovery point. Thus the minimum separation between the two planes is always maintained. Finally, the simulation results show that the method is simple and efficient.

The effect of induced fusional demand on static and dynamic stereoacuity thresholds: the digital Synoptophore

Background/aimsThe ability to extract depth from disparity may be hindered under fusional stress, as alignment of the eyes may be more difficult to maintain consistently. Therefore we aim to determine the effect of fusional demand on stereoacuity in individuals with no known binocular vision impairments.MethodsA novel static and dynamic binocular depth detection task, capable of assessing many discrete levels of stereoacuity, was presented on digital displays attached to each tube of the Synoptophore. Stereoacuity was measured with any latent deviation fully corrected and compared to that measured at the ‘recovery’ angle. This recovery angle is where single vision is restored after decompensation to diplopia, during vergence range assessment.ResultsSeventy-two subjects (50 Female, 22 Male; mean (SD) age 22 (6) years) were assessed. The amount of fusional demand was between 1 and 26 prism dioptres (PD), with a mean (SD) of 8(6)PD. Under zero fusion demand the mean (SD) static and dynamic depth detection thresholds were 322(53)” and 69(23)”. Under fusional stress these were 224(40)” and 77(21)”. There was no significant difference between thresholds in stressed and zero demand fusion (p = 0.08). Dynamic depth detection thresholds were significantly lower than static (P < 0.01).ConclusionFusional stress does not appear to impact on stereoacuity. The numerical value of the recovery point varied amongst individuals, but this represents a common point, where single vision is easily restored and binocularity well established. Due to individual differences in the ability to control a certain amount of fusional stress (e.g. vergences stress of 10PD, when recovery is 8PD, will perturb binocularity more than a person with a recovery of 20PD), previous reports may not accurately represent the effect of fusional stress. Whilst our findings are contrary to previous reports, we did not stress fusion beyond the recovery point and used a more accurate/repeatable method to measure stereoacuity.

Toward a mechanistic understanding of wettability alteration in reservoir rocks using silica nanoparticles

Traditional concepts of simple liquid spreading may not apply to nanoparticle-fluids. Most investigations pertaining to the wettability alteration of solid surfaces due to the presence of nanoparticles in the fluid are oversimplified, i.e. nanoparticles dispersed in DI-water and smooth, homogeneous, and clean surfaces have been used. From a practical enhanced oil recovery (EOR) point of view, the nanoparticles must be dispersed in either seawater or high salinity formation water containing diverse types and concentrations of ions. These ions interact with the electrostatic properties of the nanoparticles. Likewise, the oil phase may contain many surface active components like asphaltene and naphthenic acids which can interact with nanoparticles at oil-water and oil-rock interface. In reality, the rock sample is a heterogeneous, non-smooth, mixed-wet substrate with a diverse mineralogical composition. The electrical charge of minerals can vary when contacted with an ionic fluid. This can alter the electrostatic repulsion between substrate and nanoparticles and consequently the substrate can either attract or repel charged particles, including nanoparticles. Hence, the role of nanoparticles must be evaluated considering multicomponent complex fluids and real formation rock. Despite numerous reports regarding the wettability alteration of reservoir rock from oil-wet to water-wet by nanoparticles, some inherent limitations in the wettability alteration experiments prevent conclusions about the performance of nanoparticles in practical complex conditions. For instance, the wettability alteration by nanoparticles is often determined by contact angle measurements. In this method, the substrates are either aged with (immersed in) nanoparticle-fluids before conducting the experiments or contacted with nanoparticle-fluids before attachment of the oil droplet on the rock surface. Hence, in both cases, before initiating the contact angle measurements, the nanoparticles would already exist at the oil-rock interface possibly giving inaccurate measurements. The objective of this work is to investigate the mechanism of wettability alteration by silica nanoparticles pre-existing on the rock interface (conventional contact angle measurements) and using a new displacement contact angle method to better mimic the scenario of injecting a nanoparticle fluid into the reservoir already containing formation brine. The impact of pre-existing nanoparticles at the oil-rock interface (in the conventional contact angle measurements) on the contact angle measurements are examined for simple (n-decane, NaCl brine, and pure substrates) and complex (crude oil, seawater, and reservoir rock) systems on various wetting conditions of substrates (water-wet and oil-wet). The nanoparticles are dispersed in seawater using our H+ protected method [1]. Then, the effect of surface and nanoparticle charge on the contact angle is evaluated by adjusting the aqueous phase salinity. We also differentiate between the disjoining pressure mechanism and diffusion of silica nanoparticles through the oil phase by testing the attachment of nanoparticles on the rock surface.

Continuous EEG Monitoring-The Neurologist's Crystal Ball.

Time to Epileptiform Activity and EEG Background Recovery Are Independent Predictors After Cardiac Arrest Westhall E, Rose I, Rundgren M, Bro-Jeppesen J, Kjaergaard J, Hassager C, Lindehammar H, Horn J, Ullen S, Nielsen N, Friberg H, Cronberg T. Clin Neurophysiol. 2018;129:1660-1668. doi:10.1016/j.clinph.2018.05.016Objective: To investigate the temporal development of electroencephalogram (EEG) and prognosis. Methods: Prospective observational substudy of the Target Temperature Management trial. Six sites performed simplified continuous EEG monitoring (cEEG) on comatose patients after cardiac arrest, blinded to treating physicians. We determined time points of recovery of a normal-voltage continuous background activity and the appearance of an epileptiform EEG, defined as abundant epileptiform discharges, periodic/rhythmic discharges, or electrographic seizure activity. Results: One hundred thirty-four patients were included, of which 65 had a good outcome. Early recovery of continuous background activity (within 24 hours) occurred in 72 patients and predicted good outcome since 55 (76%) had good outcome, increasing the odds for a good outcome 7 times compared to a late background recovery. Early appearance of an epileptiform EEG occurred in 38 patients and 34 (89%) had a poor outcome, increasing the odds for a poor outcome 6 times compared to a late debut. The time to background recovery and the time to epileptiform activity were highly associated with outcome and levels of neuron-specific enolase. Multiple regression analysis showed that both variables were independent predictors. Conclusions: Time to epileptiform activity and background recovery are independent prognostic indicators. SIGNIFICANCE: Patients with early background recovery combined with late appearance of epileptiform activity may have a good outcome.

Clofarabine with Topotecan, Vinorelbine, and Thiotepa (TVTC) in Children and Young Adults with Relapsed or Refractory Acute Myeloid Leukemia

Background: Relapsed or refractory pediatric acute myeloid leukemia (AML) is an unfortunate reality in approximately 40% of children and young adults diagnosed with AML. Therapeutic options are limited in this heavily pre-treated patient population, many of whom have reached lifetime recommended doses of anthracycline chemotherapy. Non-anthracycline based salvage regimens are crucial to these patients who are at significant risk of life-threatening cardiotoxicity. We previously reported results of a phase 2 trial of a Clofarabine-based regimen with Topotecan, Vinorelbine, and Thiotepa (TVTC) in a cohort of patients with AML. Herein, we report on an expanded cohort of AML patients treated at Memorial Sloan Kettering Cancer Center (MSKCC) since 2007. We report our center's experience using a Clofarabine-based regimen with Topotecan, Vinorelbine, and Thiotepa (TVTC), its overall response rate defined as complete remission (CR) and its use as a bridge to hematopoietic stem cell transplant (HSCT).Patients and Methods: All patients <25 years of age with relapsed/refractory AML, defined as >10% bone marrow involvement, who were treated with the phase 2 recommended schedule of TVTC were included in this analysis. Patients received the TVTC regimen with Topotecan 1 mg/m2/day (120 hour continuous infusion, Days 0-4), Vinorelbine 20 mg/m2/dose (Days 0, 7, 14), Thiotepa 15 mg/m2/dose (Day 2), and Clofarabine 40 mg/m2/day (Days 3-7). The regimen could be administered without hospitalization in patients who did not require hospitalization for other reasons. Most patients received antimicrobial prophylaxis starting on Day 8 with Levofloxacin and fungal prophylaxis with either Posaconazole or Voriconazole. GCSF 5mcg/kg/day was initiated on Day 8. Bone marrow evaluation was performed at the point of hematologic recovery to assess response. Overall response rate (ORR) was defined as complete remission (CR) plus complete remission without platelet recovery (CRp).Results: A total of 29 patients with relapsed (n=19) or refractory (n=10) AML were treated since 2007. Eight patients (28%) had prior hematopoietic stem cell transplantation (HSCT). The ORR of the entire cohort was 59% (17/29). The ORR of patients with relapsed vs. refractory disease was 74% (14/19) and 30% (3/10), respectively. Seventeen of 29 patients (59%) received TVTC as a 1st re-induction regimen with 59% (10/17) of those patients achieving a CR/CRp. The remaining 12 patients had TVTC as 2nd or greater regimen with 58% (7/12) of those patients achieving a CR/CRp. Among the 17 total responders in the cohort, 13 (76%) proceeded to HSCT. Of those who proceeded to HSCT, 8 of 13 are alive today (62%). Median time since HSCT is 66 months (range 14 to 107 months). The most common adverse effects were febrile neutropenia in 20 out of 29 patients (69%) which was Grade 3 or less, 3 of 29 patients (10%) with Grade 4 or greater febrile neutropenia requiring ICU admission. One patient developed an abdominal mucormycosis infection. One patient developed bone marrow aplasia and died due to sepsis 45 days after receiving TVTC.Conclusions: TVTC is an active regimen for children and young adults with relapsed/refractory AML, with an acceptable toxicity profile . Non-anthracycline containing salvage regimens are especially important as patients usually receive >400mg/m2 daunorubicin equivalents during frontline therapy. The majority of responders were successfully bridged to HSCT without exposure to additional anthracycline, with approximately half of these patients demonstrating long-term survival. TVTC warrants further exploration as a re-induction regimen in a larger cohort of patients with relapsed/refractory AML. DisclosuresKobos:Janssen Research & Development: Employment.